The signs and symptoms of large bowel obstruction are:

Choice A reason:
Aspirin is an antiplatelet medication used to prevent blood clots in the arteries but is not the primary treatment for deep vein thrombosis (DVT), which is likely in this scenario. The patient's symptoms suggest a possible DVT, which requires anticoagulation therapy.

Choice B reason:
Clopidogrel (Plavix) is another antiplatelet medication, similar to aspirin, and is not the primary treatment for DVT. It is more commonly used to prevent clotting in arterial diseases such as coronary artery disease but not for venous thromboembolism.

Choice C reason:
Enoxaparin (Lovenox) is a low molecular weight heparin used for the initial treatment of DVT. It is an anticoagulant that helps prevent further clot formation and allows the body to break down the existing clot. Given the patient's symptoms, enoxaparin is the appropriate medication to anticipate for managing DVT.

Choice D reason:
Warfarin (Coumadin) is an oral anticoagulant used for long-term prevention of thromboembolism but is not typically used for initial DVT treatment due to its slow onset of action. Enoxaparin or other forms of heparin are preferred for immediate anticoagulation.

Choice A reason:
Pulmonary embolism is not a typical complication of a peptic ulcer. While serious, pulmonary embolism is unrelated to the gastrointestinal tract and would not arise from ulceration of the stomach or duodenum. It is therefore not the correct answer to the question posed.
Choice B reason:
Bleeding is the primary clinical manifestation of greatest concern with a peptic ulcer. Ulcers can erode into blood vessels, leading to gastrointestinal hemorrhage, which may present as hematemesis (vomiting blood) or melena (black, tarry stools). Severe bleeding can result in hypovolemic shock and requires immediate medical intervention, such as endoscopic hemostasis, blood transfusions, or surgery. This makes bleeding the most critical concern among the options listed.
Choice C reason:
Bowel obstruction can occur as a complication of peptic ulcer disease but is less common compared to bleeding. It arises from scarring or swelling near the pylorus, leading to gastric outlet obstruction. While serious, it is not the most frequent or immediate concern in the context of peptic ulcers.
Choice D reason:
Hepatomegaly, or enlargement of the liver, is unrelated to peptic ulcer disease. This symptom is typically associated with liver conditions such as cirrhosis, hepatitis, or cancer, and does not result from ulcer pathology.